Permit . w CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00070
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/20/2007
PARCEL: 2S 109AC - 03100
SITE ADDRESS: 13375 SW ANGUS CT ZONING: R -
SUBDIVISION: WILSON RIDGE LOT: 005 JURISDICTION: TIG
PROJECT: WILSON RIDGE
Project Description: Backflow preventer for irrigation.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
DON MORISSETTE
4230 GALEWOOD #100 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 2/20/2007 $36.25
[TAX] 8% State Surcha 2/20/2007 $2.90
Phone : Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 692 -5945
FAX 503 - 692 -0768
Reg #: LIC 7804
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 -0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By:° » Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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411 11 LC B 7804
.Plumb' 1 siy , , I ie;� :Ay::,rEB 2 0 2007 FOR OFFICE USE ONLY
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. ` ?� �� O1 d iGl Al[ Rsceio2a V / o i\ t `(7 l Permit N `,00 a V 7 11' 125 SW Nall Blvi • A , E bl isio a Plan Review
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" Phone: 503.639.4171 ax: 50 .i. •.1 "� S�nt+oy� `,Ilv D Other Permit No.:
24- Hour lnspcction Line: 503.639.'175 +' r�r
Internet Www.ci.ti ard.ar.us Date Ready H Sec Page 2 for
8 Nodtled/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
® New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. Total
❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath i 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 13375 SW Angus Court Catch basin or area drain 16.60
City/State /ZIP: Tigard, OR 97224 Drvwell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: Wilson Ridge 05 Footing drain (no. linear ft.: _ ) Page 2
Manufactured home utilities 110.00
Cross streetidirections to job site: SW Bull Mountain Road
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear fl_: ) Page 2
Storm sewer (no linear ft.: ) Page 2
Subdivision: Wilson Ridge 1 Lot no.: 05 Water service (no. linixtr ft.: ) Page 2
Fixture or item
Tax map /parcel no.: 655 A7
Absorption valve 16.60
DESCRIPTION OF WORK Baektlaw prevenler ✓ Page 2
• Landscape Backflow Device Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
® PROPERTY OWNER I 0 TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: Don Morissette Homes
Expansion tank 16.60
Address: 4230 SW Galewood Fixture /sewer cap 16.60
City /State /ZIP: Lake Oswego, OR 97034 Floor drain/floor sinkdhub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
® APPLICANT ® CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Landscape Oregon, Inc.
Interceptor /grease trap 16.60
Contact name: Ellen Sparrow Medical gas (value: S ) Page 2
Address: 12200 SW Myslony Street Primer 16.60
City/State /ZIP: Tualatin, OR 97062 Roof drain (commercial) 16.60
Phone: (503) 692 -5945 Fax: : (503) 692 -0768 Sink basin lavatory 16.60
1 Tub shower /shower pan 16.60
' E-mail:
Urinal 16.60
CONTRACTOR Water closet 16.60
' Business name: Landscape Oregon, Inc. Water heater 16.60
•
Address: 12200 SW Myslony Street Other:
City /State /ZIP: Tualatin, OR 97062 Subtotal
Minimum permit fee: 572.50
Phone: (503 -) 692 -5945 Fax: (503) 692 -0768 Residential backflow minimum permit fee: S36.25' - 4-
CCB Lie.: 7804 Plumbing Lie. no.: Pian rcvicw (25% of permit feel
l /` L Stale surcharge (1% of permit fee) < <i{s
Authorized signatur wt/l
TOTAL PERMIT FEE -/, / .5
Print name: Ellen Sparrow Date: 02/19/17 This permit application expires if a permit is not obtained within
1811 days alter it has been accepted as complete.
phone: 503.692.5945 • fax: 503.692,0768 • 12200 SW MySorlel8fitlol y sTiaalcbtiG90b ll i ab2y serv Board.
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CITY. OF TIGARD
BUILDING DIVISION r- - .
. , PERMIT #: PLIN12007-00070
t,
13125 SW Hall Blvd., Tigard, OR 97223 , , • #4, i DATE ISSUED: 2/20/.2007
Phone: (503) 639-4171 ., "omill
Inspection Requests (24 Hrs.): (503) 639-4175,
INSPECTION WORKSHEET FOR DATE: 2/21/2007 TIME: 7:00AIYI PAGE: 44
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SITE ADDRESS: , 13375 SW ANGUS CT CLASS OF WORK: ,
SUBDIVISION: WILSON RIDGE LOT #: 005 TYPE OF USE:
PROJECT NAME: WILSON RIDGE
DESCRIPTION: Backflow prevent& for irrigation. .
OWNER: DON MORISSETTE, PHONE #:.
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 2/21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message ”.
.. ,
399 Plumbing final 043627-01 503-692-5945 N „.
• '-'
Corrections /Comments / Instructions:
,7
•
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1 1 .. P,ASS fl PARTIAL APPROVAL n CANCEL 0 NO ACCESS
FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: C4-iii. Date: Z-- , Z7/D Phone #: (503) 718- Z.C9X
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